Moira Attree - Academia.edu (original) (raw)
Papers by Moira Attree
Journal of Research in Nursing, 2001
Journal of nursing management, 2009
Journal of Advanced Nursing, 2001
To explore patients' and relatives' perceptions of care and identify key criteria... more To explore patients' and relatives' perceptions of care and identify key criteria used to evaluate quality care, via descriptions of actual care experiences. A qualitative approach using Grounded Theory was adopted; data collected by semistructured interviews, from a purposive sample of 34 acute medical patients and 7 relatives, was subjected to question and thematic analysis. The nature of the care provided and interpersonal aspects of caring emerged as key quality issues for patients. Good Quality Care was characterized as individualized, patient focused and related to need; it was provided humanistically, through the presence of a caring relationship by staff who demonstrated involvement, commitment and concern. Care described as 'Not so Good' was routine, unrelated to need and delivered in an impersonal manner, by distant staff who did not know or involve patients. Empirical evidence was found which support these findings, which are in opposition of the received view that patients place greater emphasis on the technical aspects of care tasks. The quality issues identified as important by patients and relatives in this study are not always evaluated in care audits. Those responsible for evaluating health care quality might consider combining traditional (professional/technical) audit criteria with those used by health care users to achieve a more comprehensive evaluation.
Nurse education today, 2005
In this literature review, we examine to what extent patient safety is addressed within medical a... more In this literature review, we examine to what extent patient safety is addressed within medical and nursing curricula. Patient safety is the foundation of healthcare practice and education both in the UK and internationally. Recent research and policy initiatives have highlighted this issue. The paper highlights the significance of this topic as an aspect of study in its own right by examining not only the fiscal but also the human costs such events invite. In the United Kingdom patient safety issues feature prominently in the (Department of Health, 2000a. An organisation with a memory. The report of an expert group on learning from adverse events. The Stationery Office, London, Department of Health, 2000b. Handling complaints: monitoring the NHS complaints procedures (England, Financial year 1998-99). The Stationery Office, London.) policy documentation but this is not reflected within the formal curricula guidelines issued by the NMC and GMC. Yet if healthcare educational curricul...
Journal of nursing management, 2005
To explore registered nurses' perceptions of standards of nursing practice and factors that ... more To explore registered nurses' perceptions of standards of nursing practice and factors that affect nursing practice standards.
Journal of clinical nursing, 2008
To identify the beliefs and attitudes of a sample of obese and overweight Spanish women undertaki... more To identify the beliefs and attitudes of a sample of obese and overweight Spanish women undertaking a weight-loss treatment.
Registered nurses’ lack of critical thinking negatively influenced their communication with physi... more Registered nurses’ lack of critical thinking negatively influenced their communication with physicians, participation in shared decision and compliance with safety procedures. Lack of training [in critical thinking skills] is what makes us lack confidence and what makes us doubt ourselves (...) The fear of the physician saying that this is not being done well and not having enough arguments to say “Look, the criterion is that and the result is this” is what makes you keep quiet. (N8) LOW CONFIDENCE question or halt inappropriate procedures
Journal of Clinical Nursing 2010 19 8 8, Oct 1, 2010
This paper will present a synopsis of the evidence on older people?s involvement in their individ... more This paper will present a synopsis of the evidence on older people?s involvement in their individual health and care; identify current positions, approaches and challenges to promoting positive ageing through increasing older people?s involvement in their care. Methodological and practical challenges to increasing older people?s involvement in care will be deliberated. Involvement in health and care decisions can improve a person?s quality of life and satisfaction, as well as increase care quality, safety and effectiveness. Across Europe people?s levels of involvement differs in type, method and priority (Picker Institute Europe 2009). Evidence exists that older people are not as involved as they would like to be in their care (Picker Institute Europe 2009), and that involvement in care improves personal outcomes: confidence, self-esteem and self-worth, as well as health-related outcomes: compliance, self-management and satisfaction (Hanley 2004; Barnard et al 2005). Many factors influence involvement; staff attitudes and structures that affect opportunities for involvement in decision-making are critical (Elwyn et al 2001; Arnetz et al 2008). Barriers to increased involvement in care can be addressed through education that develops staff knowledge, skills and attitudes, and through policies, strategies and structures that promote active engagement of people in their health and care decisions.
This analysis explores the applications and interpretations of the extensively used, but seldom d... more This analysis explores the applications and interpretations of the extensively used, but seldom defined, concept of "quality" as it relates to contemporary nursing care. This study employed an inductive approach to describe and explain the use and meaning of the concept; data generated from the literature were also analysed to identify the predominant attributes or characteristics of the concept quality associated with health care. The analysis yielded data from which modes of conceiving, describing and explaining the concept "quality nursing care" could be induced and grounded theory could be generated. Quality emerged as a complex, multi-dimensional concept requiring further analysis and clarification. Unaware of, or undeterred by the conceptual confusion, quality care continues to be assured, controlled, evaluated and managed in the Health Service today.
International Journal of Older People Nursing, 2013
In Western society and increasingly elsewhere, death has become medicalised and &... more In Western society and increasingly elsewhere, death has become medicalised and 'hospitalised' even when people are enduring deteriorating terminal conditions such as dementia and heart failure. In an attempt to rationalise and dignify the place and manner of death, evidence is emerging that the adoption of end-of-life care pathways and models can improve the experience of the end-of-life care across a range of care settings. Each of these demands skills and knowledge in the assessment and prediction of the dying trajectory. In this study, we report complexities facing relatives, residents and nursing home staff in the awareness, diagnosis and prediction of the dying trajectory. Data were collected and analysed within a broadly qualitative methodology. The contexts were two nursing homes in the Greater Manchester area, each at different stages of implementing 'Gold Standards…
International Journal of Nursing Studies, 1996
model of the multi-dimensional concept 'Quality Care' was constructed from data generated inducti... more model of the multi-dimensional concept 'Quality Care' was constructed from data generated inductively from a concept analysis (Attree, 1993). The construction of a model was intended to assist in the clarification of this complex and abstract concept, and permit the exploration of postulated relationships between the elements. The theoretical model could also be used to construct more acceptable and credible measures which would adequately represent the multiple dimensions and perspectives of 'Quality Care'. It was anticipated that attainment of these initial theoretical stages would form a basis for the development of nursing theory and research relating to 'Quality Care'.
Nurse Education Today, 2014
A thematic literature review was undertaken to identify methodological aspects in the assessment ... more A thematic literature review was undertaken to identify methodological aspects in the assessment of safety culture and critically examine how these have been addressed in hospital-based studies of safety culture, for the period 1999-2012. The literature search included an electronic database search (BNI, CINAHL, EMBASE, MEDLINE and PsycINFO), access to websites of organizations dedicated to the enhancement of patient safety, and a manual search of reference lists of the papers included. The analysis of the 43 records included in the review revealed that discussion regarding the measurement of safety culture in the hospital setting revolves around three methodological areas, namely: research approaches; survey tools for data collection; and levels of data aggregation. To advance these discussions, robust research is needed to clarify what dimensions belong to the core of safety culture and what the main sources of safety culture variability are. Studies using a mixed methods approach to assess safety culture would be useful, since they permit the in-depth research necessary to depict the multiple components of this construct.
Journal of Research in Nursing, 2001
Journal of nursing management, 2009
Journal of Advanced Nursing, 2001
To explore patients' and relatives' perceptions of care and identify key criteria... more To explore patients' and relatives' perceptions of care and identify key criteria used to evaluate quality care, via descriptions of actual care experiences. A qualitative approach using Grounded Theory was adopted; data collected by semistructured interviews, from a purposive sample of 34 acute medical patients and 7 relatives, was subjected to question and thematic analysis. The nature of the care provided and interpersonal aspects of caring emerged as key quality issues for patients. Good Quality Care was characterized as individualized, patient focused and related to need; it was provided humanistically, through the presence of a caring relationship by staff who demonstrated involvement, commitment and concern. Care described as 'Not so Good' was routine, unrelated to need and delivered in an impersonal manner, by distant staff who did not know or involve patients. Empirical evidence was found which support these findings, which are in opposition of the received view that patients place greater emphasis on the technical aspects of care tasks. The quality issues identified as important by patients and relatives in this study are not always evaluated in care audits. Those responsible for evaluating health care quality might consider combining traditional (professional/technical) audit criteria with those used by health care users to achieve a more comprehensive evaluation.
Nurse education today, 2005
In this literature review, we examine to what extent patient safety is addressed within medical a... more In this literature review, we examine to what extent patient safety is addressed within medical and nursing curricula. Patient safety is the foundation of healthcare practice and education both in the UK and internationally. Recent research and policy initiatives have highlighted this issue. The paper highlights the significance of this topic as an aspect of study in its own right by examining not only the fiscal but also the human costs such events invite. In the United Kingdom patient safety issues feature prominently in the (Department of Health, 2000a. An organisation with a memory. The report of an expert group on learning from adverse events. The Stationery Office, London, Department of Health, 2000b. Handling complaints: monitoring the NHS complaints procedures (England, Financial year 1998-99). The Stationery Office, London.) policy documentation but this is not reflected within the formal curricula guidelines issued by the NMC and GMC. Yet if healthcare educational curricul...
Journal of nursing management, 2005
To explore registered nurses' perceptions of standards of nursing practice and factors that ... more To explore registered nurses' perceptions of standards of nursing practice and factors that affect nursing practice standards.
Journal of clinical nursing, 2008
To identify the beliefs and attitudes of a sample of obese and overweight Spanish women undertaki... more To identify the beliefs and attitudes of a sample of obese and overweight Spanish women undertaking a weight-loss treatment.
Registered nurses’ lack of critical thinking negatively influenced their communication with physi... more Registered nurses’ lack of critical thinking negatively influenced their communication with physicians, participation in shared decision and compliance with safety procedures. Lack of training [in critical thinking skills] is what makes us lack confidence and what makes us doubt ourselves (...) The fear of the physician saying that this is not being done well and not having enough arguments to say “Look, the criterion is that and the result is this” is what makes you keep quiet. (N8) LOW CONFIDENCE question or halt inappropriate procedures
Journal of Clinical Nursing 2010 19 8 8, Oct 1, 2010
This paper will present a synopsis of the evidence on older people?s involvement in their individ... more This paper will present a synopsis of the evidence on older people?s involvement in their individual health and care; identify current positions, approaches and challenges to promoting positive ageing through increasing older people?s involvement in their care. Methodological and practical challenges to increasing older people?s involvement in care will be deliberated. Involvement in health and care decisions can improve a person?s quality of life and satisfaction, as well as increase care quality, safety and effectiveness. Across Europe people?s levels of involvement differs in type, method and priority (Picker Institute Europe 2009). Evidence exists that older people are not as involved as they would like to be in their care (Picker Institute Europe 2009), and that involvement in care improves personal outcomes: confidence, self-esteem and self-worth, as well as health-related outcomes: compliance, self-management and satisfaction (Hanley 2004; Barnard et al 2005). Many factors influence involvement; staff attitudes and structures that affect opportunities for involvement in decision-making are critical (Elwyn et al 2001; Arnetz et al 2008). Barriers to increased involvement in care can be addressed through education that develops staff knowledge, skills and attitudes, and through policies, strategies and structures that promote active engagement of people in their health and care decisions.
This analysis explores the applications and interpretations of the extensively used, but seldom d... more This analysis explores the applications and interpretations of the extensively used, but seldom defined, concept of "quality" as it relates to contemporary nursing care. This study employed an inductive approach to describe and explain the use and meaning of the concept; data generated from the literature were also analysed to identify the predominant attributes or characteristics of the concept quality associated with health care. The analysis yielded data from which modes of conceiving, describing and explaining the concept "quality nursing care" could be induced and grounded theory could be generated. Quality emerged as a complex, multi-dimensional concept requiring further analysis and clarification. Unaware of, or undeterred by the conceptual confusion, quality care continues to be assured, controlled, evaluated and managed in the Health Service today.
International Journal of Older People Nursing, 2013
In Western society and increasingly elsewhere, death has become medicalised and &... more In Western society and increasingly elsewhere, death has become medicalised and 'hospitalised' even when people are enduring deteriorating terminal conditions such as dementia and heart failure. In an attempt to rationalise and dignify the place and manner of death, evidence is emerging that the adoption of end-of-life care pathways and models can improve the experience of the end-of-life care across a range of care settings. Each of these demands skills and knowledge in the assessment and prediction of the dying trajectory. In this study, we report complexities facing relatives, residents and nursing home staff in the awareness, diagnosis and prediction of the dying trajectory. Data were collected and analysed within a broadly qualitative methodology. The contexts were two nursing homes in the Greater Manchester area, each at different stages of implementing 'Gold Standards…
International Journal of Nursing Studies, 1996
model of the multi-dimensional concept 'Quality Care' was constructed from data generated inducti... more model of the multi-dimensional concept 'Quality Care' was constructed from data generated inductively from a concept analysis (Attree, 1993). The construction of a model was intended to assist in the clarification of this complex and abstract concept, and permit the exploration of postulated relationships between the elements. The theoretical model could also be used to construct more acceptable and credible measures which would adequately represent the multiple dimensions and perspectives of 'Quality Care'. It was anticipated that attainment of these initial theoretical stages would form a basis for the development of nursing theory and research relating to 'Quality Care'.
Nurse Education Today, 2014
A thematic literature review was undertaken to identify methodological aspects in the assessment ... more A thematic literature review was undertaken to identify methodological aspects in the assessment of safety culture and critically examine how these have been addressed in hospital-based studies of safety culture, for the period 1999-2012. The literature search included an electronic database search (BNI, CINAHL, EMBASE, MEDLINE and PsycINFO), access to websites of organizations dedicated to the enhancement of patient safety, and a manual search of reference lists of the papers included. The analysis of the 43 records included in the review revealed that discussion regarding the measurement of safety culture in the hospital setting revolves around three methodological areas, namely: research approaches; survey tools for data collection; and levels of data aggregation. To advance these discussions, robust research is needed to clarify what dimensions belong to the core of safety culture and what the main sources of safety culture variability are. Studies using a mixed methods approach to assess safety culture would be useful, since they permit the in-depth research necessary to depict the multiple components of this construct.